Lake Immediate Care & Clinic S C

NPI #1114208642 in Island Lake, Illinois

Provider Information

NPI Number: 1114208642
Entity Type: Organization
Organization Name: Lake Immediate Care & Clinic S C
Primary Specialty: Internal Medicine
Enumeration Date: Aug 29, 2011
Last Updated: Oct 27, 2011

Practice Location

Address: 452 W STATE RD STE D
City: Island Lake
State: Illinois
ZIP Code: 60042-8438
Phone: (847) 519-1061

Authorized Official

Name: DR. EBERECHUKWU IBE, M.D
Title: PRESIDENT
Phone: (708) 606-7219

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Internal Medicine	207R00000X	Primary

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